OBJECTIVE: To evaluate literature that discusses the treatment of fibromyalgia syndrome (FMS) with agents that involve the neurotransmitter serotonin. DATA SOURCES: Biomedical literature accessed through MEDLINE (1966-August 2001) and International Pharmaceutical Abstracts. DATA SYNTHESIS: The cause and pathophysiology of FMS remain elusive, although abnormalities in the serotonin pathway have been ...

PURPOSE: To report a Takayasu's arteritis (TA) case with an intense ocular involvement and the response to monthly bolus of Cyclophosphamide. METHODS: Case report and literature review. RESULTS: Cyclophosphamide was useful to improve the TA symptoms without any additional treatment and any secondary effects. When this therapy was discontinued the ...

Snake bite envenomation typically requires treatment with effective first aid and antivenom. There is a spectrum of envenomation seen, which includes mild envenomation, but this has not been reported previously. We report two cases of mild envenomation and describe the changes in laboratory coagulation values. The patients had a benign ...

BACKGROUND: Minocycline-induced hyperpigmentation (MIH) is a benign condition that may persist for years despite abrogation of therapy. The Q-switched ruby laser (QSRL) has been successful in removing such lesions from the skin. To date there is no documentation of QSRL or any laser being used to treat lingual hyperpigmentation associated ...

OBJECTIVE: To assess the current literature supporting a relationship between hand-arm vibration (HAV) and lower extremity clinical effects. METHODS: An initial review of the literature identified lower extremity vascular and neurological effects reported in association with HAV. A second literature review was performed with explicit search and evaluation strategies. It ...

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a rare but serious adverse effect of the selective serotonin reuptake inhibitors (SSRIs). Although many case reports describe this association, few report the effect of rechallenge with another SSRI. We present a case of an elderly patient who developed hyponatremia with ...

Males discriminate between the single most important individual component of the sex pheromone of the female cabbage looper, Trichoplusia ni (Hübner), (Z)-7-dodecenyl acetate (Z7-12:Ac), and a mixture containing Z7-12:Ac and the other five putative components. The manifestation of discrimination is not an enhancement of captures by the mixture, rather, it ...

What is angiostatin? In 1994, Folkman and colleagues published a landmark paper describing anti-tumor effects in mice with a purified fragment of plasminogen they named angiostatin (1). Although many papers have been published describing activities of cryptic polypeptides derived from plasminogen fragments, this was the first report which associated plasminogen ...

Numerous case reports of hyponatraemia followed increasing use of selective serotonin re-uptake inhibitors (SSRIs) but this adverse effect was only rarely observed in relation to citalopram. We report a case of severe hyponatraemia associated with deep coma, seizure, atrial fibrillation and muscle damage in a 92-year-old woman after only two ...

Topiramate is a medication introduced in the United States in 1997 for the treatment of epilepsy. Studies are currently underway to determine its effectiveness in the treatment of multiple conditions including bipolar disorder. It is generally well tolerated at doses commonly used in the clinical setting, however, there is little ...

In this review evidence on the impact of introducing or lowering legal blood alcohol limits on traffic safety measures is examined. There is substantial variability in the types and rigour of methods used to evaluate these legislative measures, and thus not surprisingly there is variability in the results observed. In ...

Herbal dietary supplements are often considered by patients to be safe and free from side effects. The case described here shows digoxin toxicity in a patient taking a dietary supplement not normally considered to contain digoxin. In addition to highlighting the risks of herbal supplements, this case also demonstrates the ...

TOPIC: The nature vs. nurture argument as it pertains to two brothers. PURPOSE: To explore the synergistic effects of heritability and environment in the cases of two brothers with schizophrenia. SOURCES: Review of the literature and the authors' clinical experience. CONCLUSIONS: The nature vs. nurture dichotomy may not be as ...

Friedreich ataxia (FA), the most common form of degenerative ataxia, is thought to be caused by respiratory deficiency due to mitochondrial iron accumulation and oxidative stress. Idebenone, a free-radical scavenger, protects mitochondrial function in in vitro models of FA. In a placebo-controlled crossover trial we studied the effect of idebenone ...

We investigate the effect of asymmetry of coupling on the bifurcation mechanism for the loss of synchronous chaos in coupled systems. It is found that only when the symmetry-breaking pitchfork bifurcations take part in the process of the synchronization loss for the case of symmetric coupling, the asymmetry changes the ...

Progressive multifocal leukoencephalopathy (PML) is a subacute demyelinating illness caused by the JC virus, a polyomavirus that occurs in 4-5% of HIV-positive patients. Mortality is high, and no useful therapy has been identified. Highly active antiretroviral therapy (HAART) has been reported to be effective in halting progression of the disease ...

OBJECTIVE: To review the data surrounding the use of tacrolimus for skin disorders. DATA SOURCES: Articles were obtained through a MEDLINE search of English-language literature (1990-May 2000); references of the retrieved publications were further reviewed for relevant literature. STUDY SELECTION: Orginal studies in humans regarding the use of tacrolimus for ...

Hand-foot syndrome (HFS) is a relatively common side effect of fluorouracil (5-FU) chemotherapy that has also been associated with the oral fluoropyrimidine capecitabine. Interestingly, HFS is virtually unknown to result from treatment with UFT, a combination of tegafur and uracil. Tegafur is a prodrug of 5-FU and is a component ...

High-dose intravenous immunoglobulin (hdIVIg) is being used increasingly for dermatological indications. Its mode of action is via a number of proposed mechanisms and it is not associated with the many side-effects of steroids and other immunosuppressive agents. The evidence for using hdIVIg in the treatment of autoimmune bullous disorders is ...

A series of tosylhydrazone derivatives of exo-6-substituted bicylo[2.2.2]octan-2-ones have been prepared. Thermal decomposition of the sodium salts of these tosylhydrazones gives carbene-derived products from 1,3-migration of either the C6 hydrogen (perturbed) or the C7 hydrogen (unperturbed), along with smaller amounts of alkenes derived from 1,2-hydrogen migration. The exo-6-substituent strongly activates ...

Case reports and case series have their own role in the progress of medical science. They permit discovery of new diseases and unexpected effects (adverse or beneficial) as well as the study of mechanisms, and they play an important role in medical education. Case reports and series have a high ...

Fibrates are widely prescribed as hypolipidemic drugs and are considered as safe. We report the case of a 69 year-old woman who probably developed a major allergic reaction following a Fenofibrate prescription (generic form) of 300 mg per day. Clinical features included asthenia, hyperthermia (40.5 degrees C) and slight muscular ...

OBJECTIVE: To report a case of trovafloxacin-associated leukopenia, which occurred in a trauma patient shortly after administration and resolved following discontinuation of the drug. CASE SUMMARY: A 79-year-old white man was admitted to Yale New Haven Hospital after sustaining partial amputation of his right lower leg by an industrial lawn ...

Determine whether recent US adverse event reports for several non-steroidal anti-inflammatory drugs (NSAIDs) conform to the temporal pattern observed by Dr JCP Weber in the UK in the early 1980s, i.e. a rising count in the first few years after launch presumably reflecting increased exposure, followed by a decline, presumably ...

Commonly used muscle relaxants may have serious side effects when used in critically ill patients. This case report relates some of these side effects and reviews the mechanisms by which they are thought to occur.

A high blood magnesium level is a rare but life-threatening event. This case report describes an accidental overdose of magnesium that occurred in an 18-month-old girl during a routine operation. The effects of high magnesium levels and its treatment are explained in detail.

To evaluate the effect of mirtazapine on the severity of hot flushes and bouts of perspiration in women. In two women with depression a reduction in hot flushes was noticed by serendipity during treatment with mirtazapine 15-30 mg/daily. On the basis of this observation clinical studies were extended with two ...

CONTEXT: Clinical supervision has a vital role in postgraduate and, to some extent, undergraduate medical education. However it is probably the least investigated, discussed and developed aspect of clinical education. This large-scale, interdisciplinary review of literature addressing supervision is the first from a medical education perspective. PURPOSE: To review the ...

We report a case of subcorneal pustular dermatosis (SPD) treated with tacalcitol (1alpha,24-Dihydroxyvitamin D3) ointment. A 77-year-old male had had asymptomatic, superficial, grouped pustules in annular patterns with mild background erythema for six years which affected his axillae and bilateral groin. A diagnosis of SPD was made. Topical vitamin D3 ...

BACKGROUND: Risperidone and olanzapine are atypical antipsychotics that are now widely used in clinical practice. METHOD: A MEDLINE search (1966-1999) showed that, following the introduction of these agents in recent years, 26 cases of induced hypomanic and manic syndromes have been reported during standard olanzapine (N = 10) or risperidone ...

BACKGROUND: The objectives of this study are to explore the effects of the new 1996 guidance requiring explicit demonstration of competencies on the nature of successful MFPHM Part II reports, how successful candidates claimed competency areas in their two reports and the effects of the subject areas of the report ...

As we become more experienced with the long-term use of selective serotonin reuptake inhibitors (SSRIs), more subtle side-effects may become evident. Clinicians may be aware of yawning as a side-effect of antidepressant therapy, however sparse literature exists on the topic. We present two cases in which excessive daytime yawning was ...

A male born in 1935 was diagnosed as having lepromatous leprosy when he was 17 years old. In addition to dapsone (DDS) monotherapy, he had been treated with rifampin (RMP) for 2 terms: first with 450 mg a day for 2 years when he was 39 years old; second with ...

This review of ethical theories with application to two difficult obstetric cases will allow the practicing obstetrician and gynecologist to use these theories to help resolve difficult ethical dilemmas. In the first case a pregnant human immunodeficiency virus-infected woman refuses to take triple preventive therapy, with potential fetal harm. In ...

Zolpidem (ZLP), which has selective affinity to the BZ1 (omega 1) receptor and a short half-life, is a novel hypnotic. The objective of this study is to compare the residual effects of standard clinical doses of ZLP and zopiclone (ZPC), a short-acting hypnotic marginally selective for the BZ1 (omega 1) ...

A series of 14 cases of ophthalmologic complications after intraoral anesthesia of the posterior superior alveolar nerve is presented. The most commonly encountered symptoms were diplopia, mydriasis, palpebral ptosis, and abduction difficulties of the affected eye. In all cases, these effects occurred a few minutes after injection of the anesthetic, ...

Our laboratory was asked to help with the rehydration of mummified human fingertips that had been removed from a recently deceased, unidentified female. Using a solution that was found in the archeological literature, we were able to successfully rehydrate dermal tissues to the extent that fingerprints could be taken. We ...

A field trial of efficacy of local compression immobilization first-aid technique in 42 Russell's viper bite cases was studied and only 19 were envenomed. Proper immobilization was carried out in 3/13 immobilized cases. The average time of application of the pad was 1.12 hours (range 5 minutes to 7 hours) ...

BACKGROUND: Intensive case management is commonly advocated for the care of the severely mentally ill, but evidence of its cost-effectiveness is lacking. AIMS: To investigate the cost-effectiveness of intensive compared with standard case management for patients with severe psychosis. METHOD: 708 patients with psychosis and a history of repeated hospital ...

The present study was designed to monitor the use of atypical antipsychotics in adults with intellectual disability and to evaluate the clinical effectiveness of these drugs. Twenty-one patients were commenced on an atypical antipsychotic: 12 on Olanzapine and nine on Risperidone. The ICD-10 diagnoses of the subjects were mild (13 ...

Ophthalmologic adverse effects of bisphosphonate therapy are infrequent and of unclear pathogenesis. The most common has been anterior uveitis, of which 18 cases have been reported. Onset was within 24 to 48 hours after infusion initiation, and both eyes were affected in most patients. The outcome was favorable within a ...

OBJECTIVE: The local anesthetic lidocaine has been shown to suppress tinnitus, albeit very temporarily, when administered intravenously. Long-term suppression by local anesthetics has not been reported. Bupivacaine has not been studied. Here we report a case of prolonged (1-month) suppression of tinnitus following a peripheral nerve block performed with lidocaine ...

Amphotericin B (AmB) continues to be the mainstay of therapy for serious fungal infections, despite its relatively toxic side-effect profile. Lipid preparations of the medication have been marketed in the past few years in an attempt to reduce some of these side effects, especially nephrotoxicity. Although 6 cases of severe ...

Herbal preparations are marketed as natural and safe alternatives to conventional medicines for the prevention and treatment of a variety of ailments. However, consumers may not be fully aware of their potential side effects. We report two cases of acute hepatitis after the ingestion of herbal preparations. One of the ...

Maggot infestation (myiasis) can occur in the newborn baby. However, neonatal myiasis is rare, and there is no published literature on this subject. Rapid useful information on such an esoteric clinical case can be obtained by searching the Internet. Effective medical management includes complete removal of the maggots and offering ...

OBJECTIVE: To review the role of anagrelide in the management of essential thrombocythemia. DATA SOURCES: A MEDLINE search (January 1966-August 1998) was performed using the key terms anagrelide, thrombocytosis, and essential thrombocythemia. In addition, the package insert, product monograph, and patient information pamphlets were reviewed. DATA SYNTHESIS: Recently, there has ...

Desmopressin (DDAVP) may be used to augment the action of factor VIII in mild haemophilia. Its use has been associated with serious adverse effects. We report a case of a three-year-old child with a family history of haemophilia who suffered complications due to severe acute hyponatraemia following the administration of ...

Specific phobias are not usually treated unless they are disabling. Behavioural therapy is the treatment of choice for disabling specific phobias. Pharmacotherapy is generally not considered to be effective in specific phobias, and is therefore not used for this indication. However, selective serotonin reuptake inhibitors have been reported to be ...

Alopecia and hair loss are rare side effects of psychotropic drugs. There are a few case reports on hair loss associated with tricyclic antidepressants and serotonin selective reuptake inhibitors (SSRIs), but none deal specifically with paroxetine. We report on a 37-year-old female who complained of moderate hair loss during paroxetine ...

Accidental falls in the older population are common and often result in serious injury. Although a number of factors have been recognized as risk factors for falling, the effect of footwear on postural stability is often overlooked. This article reviews the literature on the effect of various footwear features on ...